title: Smoking behaviours and cessation services among male physicians in China: evidence from a structural equation model.
abstract: OBJECTIVE
  To investigate smoking prevalence and cessation services provided by male physicians in hospitals in three Chinese cities.
  
  
  METHODS
  Data were collected from a survey of male physicians employed at 33 hospitals in Changsha, Qingdao and Wuxi City (n=720). Exploratory factor analysis was performed to identify latent variables, and confirmatory structural equation modelling analysis was performed to test the relationships between predictor variables and smoking in male physicians, and their provision of cessation services.
  
  
  RESULTS
  Of the sampled male physicians, 25.7% were current smokers, and 54.0% provided cessation services by counselling (18.8%), distributing self-help materials (17.1%), and providing traditional remedies or medication (18.2%). Factors that predicted smoking included peer smoking (OR 1.14 95% CI 1.03 to 1.26) and uncommon knowledge (OR 0.94 95% CI 0.89 to 0.99), a variable measuring awareness of the association of smoking with stroke, heart attack, premature ageing and impotence in male adults as well as the role of passive smoking in heart attack. Factors that predicted whether physicians provided smoking cessation services included peer smoking (OR 0.82 95% CI 0.76 to 0.89), physicians' own smoking (OR 0.87 95% CI 0.81 to 0.93), training in cessation (OR 1.36 95% CI 1.27 to 1.45) and access to smoking cessation resources (OR 1.69 95% CI 1.58 to 1.82).
  
  
  CONCLUSIONS
  The smoke-free policy is not strictly implemented at healthcare facilities, and smoking remains a public health problem among male physicians. A holistic approach, including a stricter implementation of the smoke-free policy, comprehensive education on the hazards of smoking, training in standard smoking-cessation techniques and provision of cessation resources, is needed to curb the smoking epidemic among male physicians and to promote smoking cessation services in China.
authors.affiliation: Department of Global Health, George Washington University, Washington, District of Columbia 20037, USA. Chenghuang@gwu.edu
authors.forename: Cheng
authors.initials: C
authors.lastname: Huang
authors.forename: Chaoran
authors.initials: C
authors.lastname: Guo
authors.forename: Shaohua
authors.initials: S
authors.lastname: Yu
authors.forename: Yan
authors.initials: Y
authors.lastname: Feng
authors.forename: Julia
authors.initials: J
authors.lastname: Song
authors.forename: Michael
authors.initials: M
authors.lastname: Eriksen
authors.forename: Pam
authors.initials: P
authors.lastname: Redmon
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Koplan
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003625:Data Collection; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010379:Peer Group; D010820:Physicians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D061845:Smoke-Free Policy / Q000331:legislation & jurisprudence; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D000074606:Smoking Prevention
keywords: Cessation; Global health; Health Services; Public policy